Psychiatry

The purpose of this elective is to provide 4th year medical students interested in child and adolescent psychiatry and/or adolescent medicine an experience in working with adolescents presenting with acute psychiatric illness. This elective will be based on the adolescent inpatient unit at Yale-New Haven Psychiatric Hospital; a short-term 15-bed unit serving patients aged 12-18. Students will gain exposure to a diverse patient population with severe mood, psychotic, behavioral, and/or substance use disorders, as well as begin to understand the intricacies of working with families and systems providing care for adolescents with significant emotional and/or behavioral disturbances. Teaching activities include daily rounds and weekly case conferences.

Length of Rotation: 4 weeks (maximum -1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

The elective is focused on the provision of outpatient mental health services for Spanish-speaking Latino communities in the United States and will cover three main themes: 1. Clinical assessment and conceptualization: Culturally-specific and linguistically appropriate clinical skills including interviewing, diagnosis, and formulation of a recovery-oriented treatment plan that includes psychopharmacology and psychotherapy. 2. Systems-based practice: Understanding the impact of community-academic partnerships and the characteristics of a culturally responsive behavioral health system of care for Hispanics 3. Recovery-oriented care: Culturally sensitive approaches to recovery from mental illness.
This elective will provide linguistically appropriate and culturally sensitive training on mental health assessments for monolingual Latinos at an outpatient mental health clinic. Clinical interviewing techniques will be reviewed with an emphasis on the Latino culture. The cultural and structural evaluations will be taught and the student will have opportunities to practice these skills. The student will initially observe crisis consultations and eventually perform supervised evaluations followed by presentations in weekly clinical rounds. The student will attend meetings of the Connecticut Latino Behavioral Health System to learn about the expansion of local culturally sensitive behavioral health services, to hear progress, challenges and outcomes. The student will recognize qualities of recovery-oriented services for mental illness and how providers can foster recovery. The elective student will engage with “peers” and identify their contributions and valued role as a member of the clinical team. “Peers” are people who have suffered mental illness, are stable and trained to support mental health services in clinical teams. The student will become familiar with the Connecticut State Department of Mental Health Recovery Initiative and how community-academic collaboration is implemented at this level. The student will review and present summaries of assigned readings of mental health services, the challenges facing minority communities, and the best practices to address them. Stigma, implicit bias, health disparities, the social determinants of mental health, recovery from mental illness, and advocacy will be the main subjects for review.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Psychiatry Clerkship

Accept Visiting Students: Yes

Learning Objectives

This elective entails etiology, clinical manifestations, and treatment of adolescent psychopathology, including eating disorders, depression, suicide, psychosis, delinquency, and the impact of physical and mental disabilities on adolescent development. Reading is supplemented with live and taped clinical material.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction(s): N/A

Student’s Class Level: 4th year

Prerequisite(s): N/A

Visiting Students: Yes

Learning Objectives

This elective offers senior medical students the opportunity to work closely with a variety of patients who are hospitalized during their participation and treatment in research protocols. The Clinical Neuroscience Research Unit (CNRU) is a thirteen-bed inpatient ward with associated outpatient clinics and basic science laboratories on the third floor of the Connecticut Mental Health Center (CMHC). Supervised implementation of novel psychopharmacology, exposure to multiple aspects of clinical and basic science research, and in-depth experience with individual and group psychotherapies are educational aspects of this elective. Patients’ diagnostic categories include depression, obsessive-compulsive disorder, schizophrenia, cocaine abuse and substance abuse and psychiatric genetics.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

Description: This four-week elective provides students with exposure to caring for older adults with mental health concerns, including mood disorders, anxiety disorders, grief, and adjustment disorders, as well as neurocognitive disorders ranging from mild cognitive deficits to dementia with complex neuropsychiatric symptoms. The student will work closely with geriatric psychiatry fellows and attendings in the outpatient evaluation and treatment of such disorders, and participate in comprehensive psychiatric evaluations, cognitive and functional assessments, individual and family psychoeducation, and treatment. The student will participate in daily team huddles which include a multidisciplinary group of physicians, nurses, social workers, and peer specialists. The student will have an opportunity to participate in group therapy as well as weekly geriatric psychiatry didactics and psychiatry department Grand Rounds. It may also be possible to rotate a half day a week with neurology (movement disorders and neurocognitive clinic) or palliative care clinic experiences, if the students is interested.

During this rotation, it is necessary to be on site at the VA Annex in Orange, CT (200 Edison Road) where the outpatient geriatric psychiatry clinic is located.

Length of Rotation: 2 week and 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th & 5th year

Prerequisite: N/A

Accept Visiting Students: Domestic: Yes – International: No

Learning Objectives

This elective includes intensive work with inpatients who suffer from major psychiatric disorders with or without substance abuse. Emphasis is on assessment, acute treatment, and arrangement of continuing care in the community. The subintern functions as an integral member of a multidisciplinary treatment team. Clinical research participation is encouraged. Opportunities are available to explore special areas of interest (e.g., forensics, psychopharmacology, administrative) with CMHC faculty and scheduled during regular clerkship rotations.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

This elective includes intensive work with patients who suffer from major psychiatric disorders, and range in age from college students to middle age. Emphasis is on assessment, acute treatment and arrangement of post-discharge follow-up care in the community. The subintern is an advanced clerk functioning as a member of the multidisciplinary treatment team, taking on primary clinician and psychiatric/medical responsibilities for patients under the supervision of senior clinicians. The elective is given on the inpatient service at the Yale Psychiatric Hospital; clinical research and outpatient involvement may be options.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

This elective affords opportunities for third and fourth year students to observe and participate in “competency to stand trial” evaluations with a clinical team who make these assessments at the New Haven Correctional Center. In addition, they may attend Law School classes with students who represent psychiatric patients, observe civil commitment procedures, attend probate court hearings, as well as the criminal proceedings in local New Haven Superior Courts. Students attend work seminars where case evaluations and write-ups are discussed and prepared, and read appropriate legal cases and psychiatric literature. Students may be able to participate in parts of evaluations of insanity defense, custody determination, and other forensic issues. They attend the Law & Psychiatry seminar during their rotation.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

This elective offers senior medical students the opportunity to learn about neuromodulation techniques in the treatment of mood disorders, more specifically, by using electroconvulsive therapy (ECT) and repetitive transcranial stimulation (TMS). Students will learn the theoretical basis for the use of ECT and TMS, among other neuromodulation techniques, in the treatment of mood disorders. They will learn indications and contraindications to treatment, the process of evaluation of patients prior to and during treatment (including use of standardized depression rating scales), how to monitor for complications and side effects to treatment, and the latest research in the field. Students will work closely with psychiatry attendings and residents at the VA in the evaluation of patients referred for ECT and TMS, and will have the opportunity for supervised participation in the performance of these treatments. Patient population includes veterans of all ages with a variety of psychiatric conditions, including mood disorders with comorbid anxiety and substance use disorders. This elective is scheduled throughout the year for a minimum of four weeks.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction:

Student's Class Level: 4th and 5th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: US/Yes; International/No

Learning Objectives

The 4-week elective experience will expose medical students to the management of complex and high-risk veterans who present to the psychiatric emergency room (PER). Students will learn basic skills in obtaining a thorough history, including the difficult topics of suicidality, homicidality, substance use and homelessness. Students will learn basic skills in crisis management, acute substance intoxication and withdrawal and comprehensive risk assessments. Students will function within the larger team of professionals and will learn the importance of a team-based approach to patient care.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Completion of the pre-clinical medical school curriculum and successful completion of the core clinical clerkships (surgical approach to the patient, medical approach to the patient and biopsychosocial approach to the patient).

Accept Visiting Students: No

Learning Objectives

In the four-week elective, post-clerkship medical students are exposed to a variety of patients with psychiatric symptoms who are hospitalized in the general hospital and/or present to outpatient medical clinics. The students are assigned to either the Behavioral Intervention Team (BIT), a multidisciplinary team that works proactively providing timely, appropriate and effective patient care in the internal medicine floors, or the Psychiatric Consultation/Liaison Service which provides psychiatric consultation in the different specialty sites including ICU, surgery, OBGYN and neurology. Elective students also spend time in an outpatient experience in the Nathan Smith Clinic, where their clinical learning focuses on HIV psychiatry and addictive disorders. During this clinical elective, students enhance their interview skills, learn the process of consultation/ liaison in the different treatment settings and enhance their core psychiatric knowledge and skills with a focus on content at the interface of medicine and psychiatry. They participate in teaching sessions provided by the attendings and fellows, and are expected to attend the service’s clinical conferences and to present cases in morning rounds. Prerequisite: required Psychiatry clerkship.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th year

Prerequisite: Completion of required Psychiatry Clerkship

Accept Visiting Students: no

Learning Objectives

Street Psychiatry is the practice of providing mental health and addiction care directly where homeless individuals reside, and involves both literally and philosophically meeting people “where they’re at.” You will join teams for street rounds/community-based drop-in clinics on a weekly basis, flexible to match with the schedules of trainees. You will participate in relationship-building with clients encountered on outreach rounds and offer services appropriate to a senior level medical student under supervision.

Locations of outreach include: homeless shelters, soup kitchens, campsites in woods, public parks, and public indoor spaces (train station, library, etc.). An orientation process will precede street-based work, which will include orientation to the safety protocol, scope of practice expectations, supervision, overview of New Haven’s homeless population, resources to link patients to existing mental health providers and/or CMHC, and information about various local services.

Length/time of rotation: Longitudinal year-long rotation offered July-June weekly; half-day per week

Student’s Class Level: 4th & 5th year

Prerequisites: Must have completed the Psychiatry Clerkship

Course director: Emma Lo

Learning Objectives

The aim of this elective is to provide the student with an intensive experience in infant, child, and adolescent psychiatry. The curriculum includes assessments of normal development and psychopathology in childhood, treatment methods, and research in major disorders of childhood. Students will be active team members of the Children's Psychiatric Inpatient Service (CPIS, Winchester, and the consultation service to the pediatric wards of Yale-New Haven Hospital from this base and in close coordination with the Director of Medical Studies, Dr. Martin). Students will be able to take advantage of the wide range of ongoing seminars, conferences, and clinical services in place at the Child Study Center. Students will have direct responsibility for patient care and will aim to function at the level of an intern. Teaching methods include seminars, conferences, field observations, ward rounds, and practical’s selected by the student following consultation with the Director of Medical Studies and the Child Study Center.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction(s): N/A

Student’s Class Level: 4th year

Prerequisite(s): N/A

Visiting Students: Yes

Learning Objectives

This sub-I experience affords the student an opportunity to gain insight into what is it like to work in clinical psychiatry. Students will function as high level clinical care providers and will be an integral part of the treatment team.

The Clinical Neuroscience Research Unit (CNRU) is a specialized service dedicated to the diagnosis, treatment and research of neuropsychiatric disorders. The unit consists of an inpatient service, as well as outpatient specialty clinics for addictive, depressive, obsessive-compulsive, psychotic, and women's behavioral health disorders. Most patients voluntarily participate in clinical research studies designed to determine the neurobiological mechanism underlying these disorders. We additionally supplement our census with patients admitted to compliment resident and student education and training. Pharmacotherapy, individual psychotherapy, group therapy, and behavior therapy are provided as clinically indicated. Clinical treatment is provided free of charge to patients. The sub-internship occurs on the Clinical Neuroscience Research Unit (CNRU) of the Connecticut Mental Health Center (CMHC).

The Sub-I is scheduled throughout the year during regular elective rotations for a minimum of four weeks.

Faculty: M. Bloch, G. Angarita, and staff. To enroll in this sub-internship, please contact Dr. Robert Rohrbaugh.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: Only offered during May-October rotation periods

Student's Class Level: 4th & 5th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: US/Yes; International/No

Intensive work with inpatients who suffer from major psychiatric disorders with or without substance abuse and who have significant social challenges often including lack of access to stable housing, work, and healthcare insurance. Emphasis is on assessment, acute treatment, and arrangement of continuing care in the community. The sub-intern functions as an integral member of a multidisciplinary treatment team and serves as the primary clinician for 4-5 patients. The sub-internship occurs on the inpatient service (4th floor) of the Connecticut Mental Health Center (CMHC). Currently the Sub-I is scheduled during the months of May through October during regular clerkship rotations for a minimum of four weeks.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

Intensive work with patients who suffer from major psychiatric disorders and range in age from college students to middle age. Most patients have access to healthcare insurance or have Medicare and/or Title XIX. Emphasis is on assessment, acute treatment, and arrangement of post-discharge follow-up care in the community. The sub-intern is an advanced clerk functioning as a member of the multidisciplinary treatment team, taking on primary clinician and psychiatric/medical responsibilities for patients under the supervision of senior clinicians. The sub-internship occurs on the general adult inpatient service at the Yale Psychiatric Hospital. Currently, the Sub-I is scheduled during the months of May through October during regular clerkship rotations for a minimum of four weeks.

Length of Rotation: 4 weeks (maximum -1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: yes

Learning Objectives

The sub-internship will build upon these skills and have an increasing level of responsibility for direct patient care. Students will take a primary role in caring for patients, with direct supervision from chief residents and attending physicians. In addition, sub-interns will act as role models and mentors for MS3 students who will be rotating simultaneously. By the end of the 4-week rotation, sub-interns should be confident with supervised but independent management of complex psychiatric patients.

Length of Rotation: 4 weeks (maximum-1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th, 5th year

Prerequisite: Completion of the pre-clinical medical school curriculum and successful completion of the core clinical clerkships (surgical approach to the patient, medical approach to the patient and biopsychosocial approach to the patient).

Accept Visiting Students: No

Learning Objectives

The purpose of this elective is to provide medical students interested in psychiatry and/or primary care an experience of working with patients with serious mental illness (SMI) in an integrated primary care setting. The Wellness Center provides primary healthcare services for individuals receiving behavioral health services at the Connecticut Mental Health Center. Patients who receive services at community mental health centers are often of low income, living in a depressed urban environment, include a significant percentage of people of color, and have limited educational opportunities and English proficiency. The goal of the Wellness Center is to improve the physical health of adults with SMI (e.g., decreased rates of obesity, hypertension, diabetes, hyperlipidemia, and tobacco and drug use) who are at increased risk for medical comorbidity and poor health outcomes.

In this longitudinal elective, students will work directly with an attending as a clinical team member one afternoon a week for six months. Students will be responsible for following patients longitudinally, building clinical alliances, leading patient encounters, and devising treatment plans and managing chronic disease (e.g. HTN, diabetes). During the elective, students will learn about the unique care considerations of patients with SMI, the social determinants of health, and the use of patient-centered approaches to promote healthy lifestyles, smoking cessation, and medication adherence.

Length of Rotation: 6 months, 1 afternoon/wk (maximum -1 student)

Scheduling Restriction: N/A

Student's Class Level: 4th & 5 th year

Prerequisite: Psychiatry 106 (required psychiatry clerkship)

Accept Visiting Students: no

Learning Objectives